Abstract 260: The Effect of Time to Bystander Cardiopulmonary Resuscitation on Survival From Out-of-hospital Cardiac Arrest From All-Japan Utstein Registry Data: A Validation of 3-Phase Sensitive Model
Background: The study objective was the effect of time to bystander CPR on survival from out-of-hospital cardiac arrest and validated 3-phase sensitive model (Weisfeldt ML&Becker LB, JAMA 2002; 288:3035–8). Several studies had the effects of them on survival from sudden cardiac arrest. These studies were old data before guideline 2005 and also model based estimation from limited sample size.
Method: We used All-Japan Utstein Registry of the Fire and Disaster Management Agency with a prospective, population based, involving consecutive patients with an out-of cardiac arrest with witness with layperson, ventricular fibrillation (VF), over 18 years, from January 1, 2006 to December 31 2008. The primary outcome measure was survival and good neurological outcome; CPC 1 or 2. We evaluated the effect and described the relationship of intervals from collapse to bystander CPR for the outcome.
Results: 24479 adults were included in the analysis. The medium time to bystander CPR was 1 minutes. Adjusted odds ratio of the average effect per a minute was 0.23 and 95% Confidence Intervals (CI) 0.17 to 0.31. Specially, the interval from 4 minutes (min) to 5 min was significantly associated with the outcome (adjusted odds ratio (OR) 0.64 95%CI 0.48–0.87), and also interval from 9 min to 10 min was associated with it (OR 0.41 95%CI 0.18–0.97). There was a significant improvement from 2006 year to 2007 years later (Figure). Change from 2006 year to 2007 year was significant (OR 1.41 95%CI 1.23–1.62).
Conclusions: Proportion of survival with good neurological outcome after VF cardiac arrest stepwise decreased with time that bystander CPR was delayed. The relationship between the outcome and the interval from collapse to bystander CPR was not linear. The critical time for the survival was 5 min and 10 min. Those data strongly supported the 3-phase sensitive model using the large population nationwide registry data.
- © 2010 by American Heart Association, Inc.